Confused about folic acid

[Andypandy30]

Hi sorry to keep asking questions. Just trying to figure things out re my deficiencies . I am taking folic acid 400 mcg one daily but as I’v been getting more frequent injections and will be self injecting at times I don’t get st my surgery . Is this enough ? I forgot to take one today and felt very dizzy and had a headache worried if it’s something else or because I got injection yesterday . It seemed to ease once I took a folic acid tonight

[Margaret-S]

Hi Andy. I'm sorry I am not able to help you on this. It's not something that I know about. It may be that you are getting too much but hopefully you may be able to get advice from our other friends on here. I'm really encouraged to see you mention self injecting and you definitely sound better about it. So looking forward to hearing that you have started. Keep focused on the better health you could have. Just wish I could afford it but am really going to look into it again and if it's feasable then drum up the courage to go for it. I honestly couldn't do a more painful one than the nurse who did mine last Monday 😣. It's still painful if I lie on that side in bed. Having said that, definitely feel much better these past 2 days. All the best 🌞

[wedgewood in reply to Margaret-S]

Self-injection need not cost much more than £1.00 if you buy in bulk ( 100 of everything you need ) You just need to find the most economical sources . Injections are the most efficacious way to get B12 into your system . As regards pain , you need to get a fine-gauged needle of at least 25 ( the higher the gauge , the finer the needle ) Injecting into the thigh is the best method for me , and totally painless . (I.M.method .) Some people chose the sub-cutaneous method , using a short needle into the tummy . Read as much as you can about the 2methids . Some people use a sort of pen which they find easier -but I don’t know anything about that .

[Andypandy30 in reply to Margaret-S]

Thank u

[wedgewood]

I can’t think that forgetting one dose of folic acid would leave you with a headache and feeling dizzy. I think that it’s just a coincidence

You haven’t quite got over one of the typical . symptoms of PA. , namely anxiety . But you are doing well now . Keep up the good work .

[Andypandy30 in reply to wedgewood]

Thank u

[deniseinmilden]

Hiya!

There's every chance that the 400mcg is not enough for more frequent injections and if I get really short I get very dizzy and terrible vertigo. I also feel very anxious and bleak.

For folate deficiency symptoms the recommendation to correct it is 5mg of folic acid (50,000 micrograms). Drs usually prescribe 5 mg (50,000 mcg) tablets for this. They sometimes prescribe 2 or 3 of these stronger ones which gives you an idea of the safety margin of the over-the-counter 400mcg ones.

It is a good idea to take a multivitamin and mineral supplement which would probably give you 200mcg and to get to 5mg you would need an extra 12 of the over-the-counter 400mcg ones every day.

If you don't feel you need this much then you could try experimenting. You could try 2 of the over-the-counter 400mcg ones every day and see if you continue to improve. If you find the improvement stops before you are well then try 3 or 4 for several days and so on. Bear in mind that you may need quite a lot (maybe up to 12 of the 400mcg tablets to meet the recommendation or the equivalent of the stronger ones that a Dr would give you) to feel at your best. If you need it, then you need it.

If you increase the amount for several days but don't get an improvement then go back to your previous dose rate and try something else.

There are a lot of factors in this and its a bit of a juggling act to get the right balance.

You are likely to also need extra potassium, magnesium and iron. You do have to be more careful with minerals as it is easier to have too much but they are just as vital. I suggest that you Google deficiency and excess of each of these so that you are aware of the symptoms and to find food and drink sources that you will like. LoSalt is a good good source of potassium and is considered to be a healthier alternative to normal table salt. Magnesium (as magnesium sulfate) is found as Epson Salts, an over the counter constipation remedy. Red meat and fish are the best sources of iron but supplements are also available.

All these affect the way you will feel and deficiencies give feelings of anxiety and depression. In addition low potassium tends to give you cramps, low magnesium makes you nervy and jumpy (and my eyesight blurred) and iron can make you very tired with breathing difficulties.

Good luck with it!

[Andypandy30 in reply to deniseinmilden]

Thank u

[Miss-guineapig]

I'm no expert but I am slowly getting my ahead around this. I inject every 10 weeks and also was initially prescribed 5mg of folic acid daily for 4 months both are prescribed from my GP. My doctor has now changed my folic acid to 5mg every 2nd day, as she believes this is sufficient following a recent blood test. She certainly takes time with me, and I trust her judgement. In addition I take 2000mg of oral VitB12 which I buy myself. I know I will absorb very little of this (maybe 5-10%) but I feel it may help in keeping my stock up. I also bought sublingual vit B12 for days that I feel not so good. To my knowledge you don't need to take extra folic acid just because you are taking more VitB12 jabs, but someone else may know better. You can never overdose on vitB12 but I'll need to check folic acid. If you take a multi vitamin plus your daily folic that would seem adequate to aid in health blood cell formation. I think the vague dizzy, headache symptoms in a bit par for the course, I certainly have these symptoms at times but in general I do ok. Best of luck Andypand30

[Miss-guineapig]

Found this information in a 'Harvard article', it said so much but I just copied this paragraph as I thought it was a bit informative but I'm sure someone on this site will share perhaps other research.

Sourece: USDA nutrient database; company Web sites

Getting too much?

Most adults should get a total of 400 mcg of folate or folic acid a day. (Women who are pregnant should get 600 mcg; those who are breast feeding, 500 mcg.) The Institute of Medicine has also set a "tolerable upper limit" of 1,000 mcg per day of folic acid from fortified foods or supplements; there's no limit on folate from food. One worry is that too much folic acid can hide the signs of anemia, an early warning of too little vitamin B12. This could allow a B12 deficiency to progress to the point of causing confusion, dementia, or severe and irreversible damage to the nervous system. Although vitamin B12 deficiency isn't common in the general population, up to one in six older people either don't get enough vitamin B12 or don't absorb it efficiently. Strict vegetarians can also have trouble getting enough vitamin B12.

[Andypandy30 in reply to Miss-guineapig]

Thank u

[fbirder]

Having frequent injections of B12 might increase your need for folic acid - for a couple of weeks if you had megaloblastic anaemia.

Otherwise you don’t need more folic acid no matter how much B12 you take. It’s like a car with an oil leak. You put lots of oil (B12) in to keep things running. But no matter how much oil you put in you don’t need more petrol (folate).

400 mcg a day should be fine. The NHS recommends 200 a day, from food and supplements. If you might possibly fall pregnant then you should be taking 400 mcg.

Any more than that should only be taken on the advice of a real doctor. If you have a severe deficiency then they may prescribe 5 mg a day. But only for a short time until the deficiency is rectified. It’s like the B12 loading doses.

Missing one dose will make very little difference to your blood levels.

You shouldn’t take other supplements without discussing it with a doctor first. Too much potassium can be as bad as too little. And using B12 will not affect potassium requirements after those first few weeks. Too much magnesium isn’t as harmful. But it is likely to give you diarrhoea. Some vitamin supplements can have far too much of some vitamins.

[Andypandy30 in reply to fbirder]

Thank u

[Ryaan]

You can ask as many questions as you like. No limits on questions.

Do you not know your Folate levels ?......400mcg is normally just to maintain levels so if you’re low or deficient on Folate then you need 5mg from GP as they’re on prescription only.

I don’t think the body uses more when you inject, it’s more of if you’re low or deficient then you won’t get the best out of injecting B12 as it needs Folate to work properly. So it’s a matter of if your levels are low or are within good range.

So if you’re on the low side it’s best to get the 5mg but if you’re levels are good then 400mcg is good enough just to maintain adequate levels.

I always try 1 thing at a time usually for a couple of weeks to see if I feel any difference.

Also good to have good levels of iron and vitamin D, so best to have a blood test if you recently haven’t had one.

Hope this helps.

[Andypandy30 in reply to Ryaan]

Thank u all . I took Denise’s advise tday and took 2 400 mcg the dizziness and headache not as evident . I know it may not make much difference in one day but I do need a folate test ? No point in a b12 as I’m getting injections . I will look for the best test tomorrow but continue with 2 for a few days . I’m also going to test vit d as tablets I was on were not bringing levels up so switched to spray . Tablets also made me feel sick . I take Iron frequently also . Will research potassium and magnesium as fbirder says . And yes I’m anxious about it all as it’s so hard to find what will work for me .

[Ryaan in reply to Andypandy30]

In the start it’s all too much to take in and you do feel confused.

I found trying 1 thing at a time really helps as you know that’s the only thing you’ve changed. Takes a bit longer but works best.

I think you should try the Folate first, see how it goes and then you can add something else unless a blood test shows you have multiple deficiencies then you can take them as you know your body is low and needs them.

Good luck, you’ll get there eventually and don’t worry as it doesn’t help, just take it easy 1 thing at a time.

You’re most welcome to ask as many questions as you like.

🙂

[Andypandy30 in reply to Ryaan]

Thank u for your kindness

[Cherylclaire Forum Support]

My folate and ferritin levels were on the low end of range- but because I was still getting hair loss, bleeding gums and split mouth despite having B12, GP gave me 3 month's supply of both- levels went up and up, finished course and they dropped again. So taking a good multivitamin&mineral supplement and another 400mcg folic acid (800 in total) daily. Also ensured that every meal had folate, ferritin and B12-rich ingredients. Still, lately, symptoms have returned, so have had blood tests to check levels again.

I think it's worth having the GP monitor your levels to make sure that you are able to maintain optimum levels, and return of symptoms and blood test results will give you a better indication of what is going on. It may take some time to get it right and stabilise it. Keep going, Andypandy30 !

[Andypandy30 in reply to Cherylclaire]

Thank you ! X

[Andypandy30 in reply to Cherylclaire]

May I ask what brand of multivitamin Cherylclaire ?

[Cherylclaire Forum Support]

It's a Holland and Barrett gold label "plus" one, can't recall the name but will get back to you. Large, dusty-looking, smell of yeast..... I'm not selling it to you very well, am I ?

Haven't yet got in touch with surgery to find out about blood tests results, but will do as soon as I can. Mum currently having heart-valve problems, which has been latest cause for concern, and so, now she is safely in hospital, all I want to do is be there and not here. Even though she is in very good hands.

(PS: she has been taking B12 tablets, and so at least I know her B12 is very high !)

[Andypandy30 in reply to Cherylclaire]

Thank you thinking of you and your mum x

[Cherylclaire Forum Support]

Sadly, Andypandy30 , although she really tried to last out until the mitral valve research procedure appointment in 10 days, she did not make it and died in St Thomas' on Saturday. Gentle, lovely, brave and very caring- very lost right now. Thanks for thinking of us .

And my blood tests ? "Normal, no action"- which I guess means all this supplementing and injecting is working. Haven't actually got a copy of them yet, but at some point I will check for myself.

[Andypandy30 in reply to Cherylclaire]

I’m so so sorry for you and I know this feeling all too well .hugs for you and I know ur mum will be willing you on the same as mine ❤️Message anytime , we are all here for you xxxxxx